It takes one punch to ruin a life, Jeremy Gilchrist, manager of brain injury services with the Southern NSW Local Health District, says.

He works each day with sufferers of irreversible brain damage – people confined to wheelchairs or beds with a full-time carer for the rest of their days. 

It’s not surprising, therefore, that his ears pricked up about 9pm on the night of June 5.

NSW Origin captain Paul Gallen was lauded by his coach Laurie Daley for punching an opponent on the chin – twice – during the series opener at the Olympic Stadium.

Daley labelled the fight “a great Origin moment”.

The punching bag, Queensland backrower Nate Myles, shrugged off the incident. A crowd of more than 80,000 rose to its feet and voiced approval.

League supporters north of the Tweed began instantly plotting revenge acts on the Blues skipper.

The reality is Gallen’s punches had the potential to inflict brain damage. The quick left-right combination could have floored the Queenslander … permanently. 

More disturbing than the fight itself was the reaction.

“The problem is young people see movies where someone gets punched 30 times, and keeps getting back up,” Mr Gilchrist said.

“We see guys get punched once, and that’s it. They’re in a wheelchair and need carers for the rest of their lives.”

The Australian Rugby League commission has since laid down the law: throw a punch at Lang Park on Wednesday and you’ll be sent to the sinbin.

It’s a commonsense decision. Any organisation that paints violence in a positive light is irresponsible, Mr Gilchrist says.

“It’s never okay to punch someone in the head. Whether it be on the football field or street, it’s a big risk.

“When you see a punch up in football game and it’s promoted as a positive thing, that only reinforces the idea you can take a heap of punches and walk away fine.

“The reality is those injuries can take years to recover… And worst case scenario is death.”

Gerry Doran is Leisure Link coordinator with Goulburn Mulwaree Council. He too works with individuals and families affected by brain damage. 

“Is it going to take someone to die before they do anything?” he said.

“If someone throws a punch like that on the street, it’s assault. If they die, it’s manslaughter. Yet it happens on the field and people like it.” 

In excess of 52,000 people will cram Brisbane’s Suncorp Stadium on Wednesday night. Most are baying for New South Wales blood. 

Any contact to Gallen’s head will be followed by thunderous chanting and applause.

The New South Wales captain knows he’s painted a target, figuratively at least, on his head.

"It will be hard not to retaliate, but I've got to look at the bigger picture,” he said when questioned about the prospect of the Queenslanders bating.

"All I want to do is win the game and the series, so if I have to cop a punch in the head to do that, then I'll do it.

“It's been a long time since we've won a series obviously, so that's the biggest goal on my mind."

Gallen has ruled out throwing a punch, too. 

 "No, I won't and I can't obviously,”?he told rugby league television show The Game Plan.

"I wouldn't say fighting has ever been allowed in rugby league but obviously it's not going to be tolerated anymore.

"To me, to be honest with you, it's a non-issue.

"I've never gone out on the field to have a fight and I don't know any coach, maybe Tommy Raudonikis is the only one, who sent his team out to have a blue."

But while ever supporters anticipate fights, players tackle with swinging arms, referees opt against sending assailants from the field and administrators promote violence, the risk of brain damage - or death – remains.